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NMSJC EHD Page 1 of 1 2015-02.11 17:59:45 (GMT) DEM 4157072038 From: Ed MacDaniel <br />ECEI E® • EHD LOG NUMBER <br />■ II6z SAN .IOAQUINCOUNTY ■' FEB 112015 ENVIRONMENTAL HEALTH DEPARTMENT O Oq <br />�77 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />ENVIRONMENTALHEALTtflephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br />PERMITISERVICES PUBLIC RECORDS RELEASE APPLICATION <br />a <br />APPLICANT; EDWARD MACDANIEL <br />ADDRESS: 3210 GOUGH ST #105 <br />PHONE (1): 415-240-3205 <br />PHONE <br />NESS/AGENCY: GRS GROUP <br />CITY/STATEIZIP-SAN FRANCISCO, CA 94123 <br />FACSIMILE: 415-707-2038 <br />Please allow 10 business days from date of application subm'Ittal for the records to be available. <br />Staff will contact you to Fimgan ppointment.dat nd time to review the requested records. <br />❑ CHECK BOX TO EXPEDITE DUES $ 00 EE (CASH OR C ECK NLY) - REQUEST PROCESSED IN 3 BUSINESS DAYS <br />SIGNATURE OF APPLICI /I / 1 / _ DATE 2/11/2015 <br />Electronic Information: ❑ List jU Map —'Description: <br />FILE ADDRESS <br />EHD USE ONLY <br />- <br />Street <br />Street Name <br />City <br />1 <br />500 <br />SOUTH BECKMAN ROAD <br />LODI <br />—�3. <br />t(fnit <br />2, <br />1025 <br />851 <br />INDUSTRIAL WAY <br />LODI AVENUE EAST <br />LODI <br />LODI4 <br />6. <br />:=dnit <br />6 <br />7.1'NV4ttl <br />I <br />e t(_ -0I f <br />AA& ( (Mev.al ti111 j Q. Unit 5 <br />8. <br />9. <br />yr <br />�'(fj i Unite <br />10. <br />Specino Date Range of Information Requested_ From <br />® UNDERGROUND TANK (UST) CLEANUP SITE (LOP) <br />Q OTHER CLEANUP SITE (NON -LOP) <br />Q UNDERGROUND TANK (MONITORINGIREMOVAL) <br />Xj ABOVEGROUND TANK <br />0 HAZARDOUS WASTEIHAZARDOUS MATERIALS <br />❑X TIERED PERMITTED FACILITY <br />❑ TATTOOIBODY PIERCING <br />MEDICAL WASTE FACILITY <br />HOUSING ABATEMENT <br />FOOD FACILITY <br />CHICKEN RANCHI DOG KENNEL <br />MOTELIHOTEL <br />POOIISPA <br />COMPLAINT/RESPONSE RECORDS <br />0 SOLID WASTE FACILITYIVEHICLE <br />Q WASTETIRE <br />❑ DAIRY <br />© WASTEWATER TREATMENT PLANT <br />❑ PUMPER TRUCKiYARDICHEMICALTOILETS <br />® LAND USE APPUCA110M SITES <br />❑ OTHER (PLEASE SPECIFY) <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY -FRIDAY 8:00 AM-6:OOPM (EXCLUDING HOLIDAYS) <br />1. List uo to ten addresses in the space above. Select the type(s) of files from the list above by checking the appropriate <br />box(ea). At Iaaat one file type MUST be selected. Fax to (2091464.0138 or mail to the address indicated above Address <br />ranges will not be accepted. Applications received after 3:00 pm will be processed the text business day. <br />2. For assistance in identifying the nature and content of EHD records, please contact EHD at the number noted above. <br />3. The EHD will notify the applicant if any EHD files exist. An appointment for review will be confirmed approximately tan (10) <br />days after receipt of application. The files will be held for a maximum of five business days for review. Appointments <br />should be scheduled accordingly. <br />4. Any file not returned in the same condition as released will be reorganized by EHD staff at the expense of the applicant. <br />._ .... «... 2-1;,e.,r may ranuire a 5130 de t osit orior to review. """BOXED ARE4 - EHD USE ONLY"' <br />..r .�... ......._ _ __-._ _. _ <br />ov:d0t i�4tC 2 D.n�v v n�fU3 (uf i tM (ia; cIJ t ; t wa- ST, LI C <br />❑ Records provided by Staff -PPR Complete. Stan Name: <br />.,. <br />MDMD 9-M <br />— Received Time Feb, 11. 2015 10:00AM—No.809 <br />